I have a comment. My doctor told me that I could be on Combvir and Sustiva for 60yrs, as long as I do not miss a dose (which I won't) and that I do not re-infect myself (which I won't). My question, do you think my doctor is just exersicing good "bedside manner"?

A Guy in Brooklyn

Response from Dr. Little

No I don't. The truth is - IF you do not develop drug resitance or toxicity which force you to change therapy, there is no data or reason to believe that you will fail this regimen ever. The difficulty is that few people can maintain this type of superb discipline for years on end. There are situations in which people fail without missing doses, but this may mean the regimen was never strong enough to prevent viral replication and resitance developed anyway. As a general rule, if your viral load goes to less than 50 AND STAYS THERE, you should be able to stay on a regimen for a very long time - NO ONE knows how long - these potent drugs have only been around for about 6 years now and some of the original people who started the potent combination regimens back then are still doing fine. Compliance (taking your drugs faithfully) and reducing toxicity are the biggest long term problems which limit the duration these drugs can be used.

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